Effect of Hepatectomy Combined with Microwave Ablation of Spleen in Treatment of Hepatocellular Carcinoma Complicated with Hypersplenia: A Retrospective Analysis of 34 Cases
LI Feng,CHENG Guang-she,LIU Xu-chen
Department of Pathology, Tongchuan People' s Hospital, Tongchuan (727100), China
Abstract:
Objective To investigate the safety and efficiency of hepatectomy combined with splenic microwave ablation for treatment of hepatocellular carcinoma (HCC) complicated with hypersplenia. Methods The patients (34 cases) undergoing hepatectomy combined with splenic microwave ablation for HCC complicated with splenomegaly and hypersplenism which was secondary to cirrhosis were retrospectively analyzed in this study. The ablated volumes of spleen were calculated by enhanced CT scan and the whole blood count and liver function were examined pre- and post-operation. All patients were undergoing 6-months follow up to monitor the complications after surgery. Results Thirty-four cases had an average of (35.3±2.4)% for spleen ablated volumes. The WBC level [(12.44±4.45)× 109/L] 1 day after surgery was significantly different from that before surgery [(3.83±1.02)×109/L], with statistical significance (P<0.01). The average peripheral blood plate count was (41.04±14.88)×109/L before surgery, which gradually increased after surgery and reached (113.45±58.33)×109/L 2 weeks after surgery. The difference of peripheral blood platelet count before and two weeks after operation was significant (P < 0.01). The liver function ALT and AST were both increased 1 day after surgery [(564.5±529.8)U/L and (429.1±318.3)U/L], respectively, compared with that before surgery [ALT, (32.8±12.2)U/L; AST, (34.1±10.7)U/L], the differences were statistically significant (P<0.01). However, ALT was restored to (56.7±43.4)U/L and AST was restored to (38.8±21.4)U/L 7 days after surgery, and the differences were not statistically significant (P>0.05). A review of CT in 1 month after surgery confirmed that the volume of spleen ablation in all patients accounted for [(24.9±4.3)%] of the total preoperative spleen volume. Conclusion It is a safe and effective procedure for HCC patients complicated with splenomegaly and hypersplenism which was secondary to cirrhosis undergoing hepatectomy combined with splenic microwave ablation.
